Individual
MS. ELIZABETH FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Mailing address
2300 FOOTHILL BLVD, ROCK SPRINGS, WY 82901-5610
(307) 352-6677
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP-139
WY
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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